Objectives
This study aimed to examine the characteristics of foreign-born abortion patients compared to those born in the Unites States and to explore whether barriers for foreign-born patients varied by state Medicaid coverage of abortion care.
Study design
We used data from the Guttmacher Institute’s 2021–2022 Abortion Patient Survey, a national sample of patients obtaining clinic-based abortion care in the United States. We compared sociodemographic characteristics of foreign- and US born respondents, as well as barriers to care. Among foreign-born patients, we compared those in Medicaid coverage states vs states that restrict Medicaid coverage.
Results
Some 12% of the 6429 respondents were born outside the United States. Compared to US born patients, they were less likely to have Medicaid coverage and more likely to be Asian/Native Hawaiian/Pacific Islander or Hispanic, to have no health insurance, and to have completed the survey in Spanish. In addition, foreign-born patients were more likely to report delays because they did not know where to get an abortion (18.3% vs. 12.6% for US born). Compared to foreign-born patients living in Medicaid coverage states, those in non-Medicaid states reported multiple barriers, particularly related to cost: respondents in non-Medicaid states were three times as likely to pay out of pocket for abortion (75.8% vs 27.4%) and five times more likely to rely on financial assistance (24.1% vs 4.8%).
Conclusions
Foreign-born abortion patients face knowledge and financial barriers to accessing abortion care compared to those who are US born, and these financial burdens are amplified for those living in non-Medicaid coverage states.
Implications
Abortion patients born outside the United States may have overcome many obstacles to obtain care. Expanding state Medicaid coverage of abortion could reduce cost burdens for foreign-born populations.